目的:观察多环与单环套扎在肝硬化食管静脉曲张(EV)出血急诊内镜治疗后临床疗效的异同.方法:75例急诊内镜诊断为EV或合并胃底静脉曲张上消化道出血患者随机采用多环或单环橡皮圈套扎治疗,分为多环套扎治疗组和单环套扎治疗组.多环套扎治疗组40例,根据EV程度给予单位点2环、3环或4环套扎治疗;单环套扎治疗组35例.合并胃底静脉曲张须先给予硬化剂聚桂醇+组织胶+硬化剂方法注射治疗.单环套扎治疗再出血患者改用多环套扎治疗.结果:多环套扎治疗组治疗后胃镜复查EV完全消失8例,基本消失26例,EV消失率85％;单环套扎治疗组治疗后胃镜复查EV完全消失5例,基本消失15例,EV消失率57％;2组比较存在显著性差异(P＜0.05).1年再出血率多环套扎治疗组为5％,明显低于单环套扎治疗组的23％ (P＜0.05).改用多环套扎治疗的再出血患者曲张静脉明显消失.结论:多环套扎治疗EV效果优于单环套扎治疗.

Objective:To inv es tigate the usage of low extremity artery color Doppler imaging in elderly pati ents with type II diabetes mellitus (DM)and its clinical significance.Methods :The elderly patients with DM in our hospital accepted the ex-amination of l ow extremity artery color Doppler imaging from bottom to top.The inner caliber ,IMT,atheromatous plaques and blood flow spectrum of lower extremity artery w ere measured and compared with the control 's.Results:①The thickness of IMT and atheromatous plaques were thicker than the control group's(P0.01 ).②The check-out rates of marked narrow segments and occlusive segments in the low extremity artery in patients group were significantly higher than the c ontrol group's (12.64%vs3.19%and1.39%vs0,P0.01,respe ctively),the most of marked narrow segments and occlusive segments were locat ed in the small arteries under the knees(90.11%and91.30%,respectiv ely).③18.8%of non-symptoms patients had marked narrow and?or occlus ive arteries and the check-out rates of narrow segments and occlusive segment s in patients with symptoms were higher than the non-symptoms '.Conclusion: The tunica intima and plaque of low extremity artery in elderly patients with type II DM could be clearly displayed by the high resolving power B-mode ultras ound.The narrow extent and occlusive segments could be judged by united with C DFI and the measurement of frequency spectrum,the measurement was especiall y suitable for the small arteries under knees.